What Eczema Is
First of all, it’s very important to understand eczema in order to combat it. It’s actually a combination of two factors: a weak skin barrier, and a overreactive immune system. Our skin is meant to protect us, but it’s imperfect. In dry climates especially, we can get tiny cracks in our skin barrier, which lets small irritants get into our bodies, such as dust mites, and then our immune systems over react and cause an itchy rash. This is why eczema is worse in the winter, because our skin isnt as healthy. Also, people with eczema often have other allergies, or asthma which is related. It’s very useful to think of your eczema as an allergy… avoiding irritants is key to staying itch-free, and staying itch-free is key to keeping your skin healthy. If you don’t scratch, you wont have eczema. They did a terrible experiment in the 50’s on a little boy with eczema, they tied him down to his hospital bed and without being able to scratch himself, his eczema healed in two weeks. I dont have a online source for this, I read it in “Eczema Free For Life”, which BTW is a great read, and where I got much of this information.
Possible allergens include:
- Dust mites
- Pet hair/dander
- Various ingredients in beauty products, cleaning products
- wool or other types of fabric
These may or may not cause a reaction for you, they are just the most common allergens to watch out for. Dust mites are everywhere and they are the first culprit to try and avoid. This means washing your bed sheets every 10 days or so, using clean towels, and wearing freshly laundered clothes everyday. Yes, it’s very high-maintenance, but if you are suffering, it’s entirely worth it. Also, once your eczema is clear, you can get lazier with this. Find out your particular needs! Sometimes, in the summer, in the right climate, I can wear my clothes twice or three times and wash my sheets every 14-18 days without issue… although I just prefer fresh sheets now. I highly recommend a blanket with a duvet cover, so you can wash the duvet cover instead of the whole blanket every 10 days.
Fragrances are also a common irritant and everywhere. It’s subtle, but worth trying to occlude to see if it impoves your skin. That means avoiding fragranced moisturizers, soap/bodywash, laundry detergent, even avoid your perfume/cologne and maybe even switch your deo. The health food store is a great place to shop for eczema sufferers, because most formulations are much more mild then conventional products. It’s also the only place I get my laundry detergent because I like scents like citrus and lavender and I find that essential oils dont bother me, but synthetic fragrances do. But we’re all different.
If you live in a dry climate, get a humidifier! It makes such a huge difference to spend the majority of your time in a humid, skin-friendly environment. I used to live in Canada, and in the wintertime my humidifier is running everyday to prevent those tiny cracks in your skin barrier.
This is going to sound counter-intuitive because of previous advice, but dont have a hot shower every day or use too much body wash. Baths are gentler on the skin then showers, and retaining the moisture on your skin is very important, which might mean bathing every other day. I personally, use an oil cleanser, (specifically Exomega Cleansing Oil which works great without overdrying) and I only use it on the parts of my body that I think are dirty, and I use a tiny amount. I rarely exfoliate either, because that will cause micro abrasions to your skin barrier that will make your eczema worse. If I do exfoliate, it will be with a damp facecloth, used very gently. DEFINITELY not a rough glove, or loofah, or crushed nuts or microbeads. Treat your skin like you’re a baby, and you will be rewarded.
It’s important to try and retain the natural oils on your skin, so be hygienic and get rid of bad smelling bacteria, but try and leave your skin alone as much as possible. Cold water is actually best for your skin, and stops itching. If I have a “eczema attack” which is when I feel SUPER itchy for some reason, I will have a cold shower, and it feels just as good or better then scratching but without the damage.
Next, find the right moisturizers, and layer them. You need a face moisturizer that’s lighter and more suitable for the sensitive areas of the face, and you need a good everyday body lotion, and THEN you also need a heavy cream for problem days/areas. I have more like 6-7, but I’m obsessed. As soon as you get out of the bath/shower, pat dry, apply generous amounts of lotion and massage it all in. Wait a few minutes for it to absorb, and apply the thicker cream on top of any areas that you experience dryness. It’s ok if it gets greasy, you just gotta give it time to absorb after. I prance around naked for like 20 mins after bathing, covered in moisturizers. I like to think it’s sexy instead of dorky. 🙂
- Exomega Cleansing Oil
- Dr. Bronner’s Mint Soap
- Aveda Rosemary Mint Body Wash
- Cetaphil cleanser
- Baby wash (fragrance free)
- Spectro Gel for Sensitive Dry Skin (some of these may be meant for your face but they are just as good at cleaning your body, etc)
Face moisturizer recommendations:
- Clinique Dramatically Different Lotion
- Cetaphil facial lotion
- Cetaphil Restoraderm Skin Restoring Moisturizer, which is formulated specifically for eczema/atopic dermatitis. It’s very important to apply moisturizer to DAMP skin in order for it to be the most effective.
(Stuff that says for atopic/sensitive skin and fragrance free is worth a shot if you cant find these two)
Body Lotion recommendations:
- Eucerin Original Lotion
- Cetaphil moisturizing lotion
- E45 lotion
- cliniderm soothing lotion
- Avene or Exomega
- Vaseline Creamy: Problem Skin Therapy (literally got me through being a poor teenager, it’s super cheap and effective)
- Aquaphor is the most dermatologist recommended
- Eucerin Healing Ointment (this goes on thick like fucking wax… but it works!)
- E45 Cream
- Skin Food by Weleda (if you wanna splurge on something delicious smelling instead of these somewhat medical smelling ones)
Aveeno Eczema Therapy with colloidal oatmeal is an awesome, steroid-free option. Again, applying it to damp skin will give you the best results.
“I never, ever, ever use steroids to treat my eczema. Not even 1% hydrocortisone cream. I have permanent scarring on my neck and the inside of my elbows from overuse of steroid creams as a kid. They ultimately made the problem way worse for me, and my eczema has never been better since stopping all use. Withdrawal from steroid creams can be brutal but it is SO WORTH IT.”
Not great for you, so use sparingly, and if you ACE your routine with the above tips, you shouldn’t need them. I will still use them occasionally, because I have no patience. If I have a breakout of eczema, I will definitely treat with meds. But I dont usually need to, as long as I stay vigilant 🙂 Get a Dermatologist, your GP will just prescribe you the weakest, shittiest formulation steroid to get you out of his office, because he’s been taught to err on the side of caution instead of getting you on the best shit. It may not be strong enough, it may not be the right formulation for the area of your body. My dermatologist, (who is awesome, they are not created equal so shop around if you don’t like yours… seriously it’s like finding the right hair stylist) he gives me three prescriptions, a mild hydrocortisone lotion for my face that absorbs well and isn’t sticky, a liquid that I can squirt on my itchy scalp, and a strong triamcinolone ointment that I can put on the eczema on the rest of my body.
Basically, once you are healed you can act pretty normally. You wont be as reactive or itchy. BUT, if I for instance have to crash at a friends’ and they are a slob and have 3 cats… I will likely wake up covered in eczema. This is what I will do:
- Take a cold shower or warm bath with vinegar and sea salt.
- cover myself in lotion
- cover myself in cream
- apply steroids to rash
- put on clean cotton clothes that cover most of my body
- change my bedsheets
- buff down my nails so they are dull and I cant scratch
- avoid alcohol/smoking/drugs
- vacuum, wipe shelves, make it super clean. Bonus tip for ladies, trans and/or fashionable men: fake nails literally means you’ve put plastic nibs on your fingers and cant really scratch yourself as much. Your eczema will improve!
EDIT: The cold shower trick works for just your hands too, if you have eczema on your hands, and you cant stop scratching them, rinse your hands under cold water and the itching will be relieved.